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The safety of sildenafil has not been studied in the following sub-groups of patients and its use is therefore contraindicated: severe hepatic impairment, hypotension blood pressure 90/50 mmHg recent history of stroke or myocardial infarction and known hereditary degenerative retinal disorders such as retinitis pigmentosa a minority of these patients have genetic disorders of retinal phosphodiesterases A medical history and physical examination should be undertaken to diagnose erectile dysfunction and determine potential underlying causes, before pharmacological treatment is considered and see it here.

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